Surgical Exploration for Intestinal Perforation in Extreme Preterm Neonates

Gastrointestinal perforation and peritonitis in preterm infants are most often due to necrotizing enterocolitis. These neonates are usually critically ill with multiorgan involvement and pose a challenge with regard to timing for definitive surgery. Peritoneal drainage is only a temporizing measure. Meticulous pre- and intra-op stabilization is mandatory for timely surgery. We describe a sick 710 g neonate where the perforation was the aftermath of intestinal obstruction from a mid-small bowel intussusception. This lays emphasis on considering other differentials for hollow viscus perforation even in extreme preterm neonates; these require surgical exploration and correction. The baby recovered well after primary resection anastomosis and several weeks of intensive care.